The Dual Diagnosis Model: Treating PTSD and Addiction

Today I came across a very well-done video that addresses the dual diagnosis model – treating PTSD and the accompanying addiction issues at the same time. I sent it to my boys.

While 70% of our population has experienced trauma, only 8% develop PTSD. Statistics are varied on the number of people who have co-occurring trauma and addiction disorders, but all experts agree that having PTSD increases the likelihood of also engaging in substance abuse/addiction, and having a substance abuse/addiction issue increases the likelihood of having PTSD. One in three people in addiction recovery also have PTSD.

PTSD is one of the most debilitating mental disorders. It results in intense anxiety, intrusive memories, and nightmares/flashbacks. It is caused by any physical or psychological trauma that leaves the individual feeling powerless and out of control: military combat, violent assault, natural disasters, sexual assaults, and childhood abuse are some of the root causes of PTSD. Sexual abuse is the most common cause for PTSD and addiction among women according to the National Center for PTSD.

Studies indicate that an integrated treatment plan for both PTSD and substance abuse is the most likely to result in a better quality of life for sufferers. The integrated treatment plans include individual psychotherapy, counseling sessions with others suffering the same co-occurring disorders, couples/family counseling, membership in a 12-step program, and often medication therapy.

The people who develop PTSD after experiencing trauma have an intense perception of helplessness in the face of their trauma and, generally, have a history of trauma. The greater the perception of helplessness, the more likely we are to become trapped in our hyper-arousal cycle, meaning we stay in a heightened state of fight-flight-freeze reaction; we are never fully at rest, always vigilant, and have a distorted perception of threat.

Addiction is our own attempt to self-regulate some of the symptoms of PTSD. The problem is that the result of addiction is often that the symptoms of PTSD become more severe.

Experts agree it is not possible to treat one without the other, and a sufferer does not need to achieve sobriety to benefit from PTSD treatment. It is a critical factor, though, that the sufferer recognize and understand how the addiction helped her survive. At Hazelden, in both group therapy and in Seeking Safety, we learned about defining and setting boundaries, treating ourselves with greater compassion, communicating openly and honestly, and building healthy relationships.

The work is intense. But it is worth the struggle.

God! Grant me the SERENITY to accept the things I cannot change, the COURAGE to change the things I can, and the WISDOM to know the difference. Peace!